Malocclusion In Adolescents Research Articles

Diagnostic considerations and orthodontic treatment approaches of adolescents with the dentoalveolar form of class II malocclusion

Relevance. Class II malocclusion (distal occlusion) is a common pathology of the maxillofacial region in the sagittal plane and is one of the most prevalent malocclusions. Studies confirm that Class II malocclusion in adolescents exhibits significant variability, prompting the development of various treatment approaches using both removable and fixed orthodontic appliances. The challenges of adolescence include concurrent physiological and psychological changes, which can complicate the treatment process.Purpose. To enhance the effectiveness of orthodontic treatment for patients with the dentoalveolar form of Class II malocclusion by utilizing the Rotation-Torque Index (RTI).Material and methods. A study was conducted on 49 residents of St. Petersburg with physiological occlusion types, who were included in the control group. The main group comprised 95 adolescents (aged 12-18) with the dentoalveolar form of Class II malocclusion classified into three levels of severity, based on the proposed working prognostic classification.Results. A new method was developed to calculate a coefficient that describes the relationship between the position of the upper and lower jaws and the torque of the central incisors. This coefficient helps predict treatment outcomes and guides the selection of the optimal treatment strategy. The Rotation-Torque Index (RTI) was introduced to quantify the relationship between the position of the jaws in the skull (SNA, SNB) and the inclination of the central incisors of the upper jaw relative to the nasal line (NL) and those of the lower jaw relative to the mandibular line (ML).Conclusions. Based on the Rotation-Torque Index (RTI), a working prognostic classification and treatment strategies for patients with the dentoalveolar form of Class II malocclusion were proposed.

Three-Stage Non-Surgical Treatment of Skeletal Class III Malocclusion in Adolescents—A Report of Four Cases with Long-Term Follow-Up

(1) Background: Postponing orthodontic treatment in Class III malocclusion until deterioration and growth cessation to perform orthognathic surgery does not seem to be an optimal solution for every patient. This report describes short- and long-term outcomes for nonsurgical treatment of four adolescents with severe Class III malocclusion. (2) Methods: Four patients (aged 13–15 y) with skeletal Class III (Wits appraisal below 7.5 mm) started a three-stage treatment, consisting of a six-month-long phase I and involving orthopedic treatment with an individual chin-cup. Phase II involved orthopedic treatment with a bonded Haas-type expander on acrylic splints, a face-mask, a lower fixed appliance and Class III elastics; phase III involved full fixed appliance, elastics and reuse of the individual chin-cup. Pre and posttreatment cephalograms were analyzed and superimposed. (3) Results: Improved skeletal and dental relationships and facial appearance was achieved in all patients. Wits appraisal, angles ANB, ANPg and lower face height increased; an improvement of overbite was noted. (4) Conclusions: Severe skeletal Class III in adolescents may be successfully treated with combined orthopedic/camouflage treatment with a Haas-type expander on acrylic splints, Class III elastics, fixed appliance and orthopedic devices (individual chin-cup and facemask) with a very good compliance.

Diagnosis and treatment of class Ⅱ malocclusion in adolescents

Class Ⅱ malocclusion is one of the factors inducing poor appearance and occlusal dysfunction in adolescents, which affects their physical and mental development. The success of treatment in correction class Ⅱ malocclusion in adolescents is dependent on the appropriate choice of therapy timing and methods, because of multifaceted causes. And puberty represents an essential period for development improvement. In the meantime, precise risk prevention and management are also conducive to the enhance treatment outcomes. A comprehension of the diagnosis, therapy, and risk control of adolescents class Ⅱ malocclusion will be discussed.

Brass wire ligation for treatment of the ectopic eruption of the mandibular second molar: a case report.

Ectopic eruption of the second permanent molar is a tooth replacement disorder during adolescence. If not treated in time, it can cause hard tissue of the adjacent first molar resorption, early tooth loss, decreased chewing efficiency, and other serious malocclusions. Timely detection and treatment of ectopic eruption of the second permanent molar are of great significance in preventing malocclusions in adolescents and establishing normal occlusion relationships. However, current case reports on the ectopic eruption of the mandibular second molar are relatively rare and are mostly concentrated on surgical and orthodontic treatments, and long-term follow-up is lacking. This paper reports a case in which brass wire ligation was used to treat ectopic eruption of the mandibular second permanent molar, allowing the permanent teeth to erupt smoothly and establish a normal occlusion. The patient was observed for five years after the operation. The occlusion was stable, and the tooth root development, pulp vitality, and periodontal conditions were normal. This paper provides a clinical approach that is short in treatment duration, simple, and minimally invasive for young mandibular second permanent molars with moderate mesial inclination and partial eruption. This method is of importance in helping children establish physiological occlusion.

Prevalence of Malocclusion among Adolescent Children Visiting Dental Department in a Tertiary Care Centre

INTRODUCTION: Malocclusion is defined as an irregularity concerning teeth alighnment and/ or their relationship during dental occlusion beyond the range of what is accepted as normal.The study was conducted in order to identify prevalence of malocclusion in adolescents visiting dental department of a tertiary care centre at Dhanusha district of Madhesh Pradesh. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted at Out-Patient Department of dental department of Janaki Medical College and Teaching Hospital (JMCTH) with participants aged 13-19 years irrespective of gender. Total of 600 adolescents were examined for malocclusion like overjet,overbite,spacing,crowding,rotation and missing tooth. Angle’s Classification was used to define malocclusion in participants. RESULTS: 93.8% of participants had some sort of malocclusion. Highest prevalence of Angle’s Class I(68%) followed by Class II(21.3%) and Class III(4.5%) was found.40.5% had increased overjet, 33.5% have deep overbite and 31.2% have crowding. 37.25% of participant had rotation of tooth. CONCLUSIONS: The study concludes with the fact that Angle’s Class I Malocclusion is the major malocclusion presenting in OPD of JMCTH. High percentage of adolescents with permanent dentition having some sort of malocclusion also seems to be concern which can affect future self confidence and much more expenditure on treatment and maintenance.

The prevalence of malocclusions in patients seeking orthodontic treatment at COMS from Chitwan District of Nepal

Background: Malocclusion is the abnormal relation between maxillary and mandibular teeth which leads to various problems like esthetics, phonation, mastication, psychological and social problems. The prevalence of malocclusion is highly variable and its range is very wide and heterogeneous. Aims and Objectives: To assess the prevalence of various malocclusion traits and to evaluate the orthodontic treatment need based on the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN) among the patients visiting the College of Medical Sciences (COMS), Bharatpur, Chitwan. Materials and Method: A total of 530 patients visiting dental OPD, College of Medical Sciences, Bharatpur, Chitwan were included in this study among which 288 were male and 242 were female patients. Out of the total 530 subjects, malocclusion was observed in 359 individuals. Therefore, all subsequent results and fidings reported in the study are based on these 359 subjects exclusively. Intraoral examination was carried out to assess malocclusion based on Angle’s classifiation, overjet, overbite, open bite, crowding, spacing, and crossbite. The statistical test employed in the study was the Chi-Square test, which was utilized to assess the presence of a signifiant difference. Result: The present study showed that Class I (55.2%), malocclusion was most prevalent followed by Class II (40.9%) and then Class III (3.9%). Increased overjet (41.2%), deep overbite (40.7%), anterior crowding (70.8%), midline spacing (17.5%), and anterior crossbite (16.4%) were more prevalent occlusal traits. DHC (Dental Health Component) of IOTN (Index of Orthodontic Treatment Needs) showed more in grades 1 and 2 (61.88%) followed by grades 4 and 5 (26.03%). Conclusion: Class I crowding was the most prevalent malocclusion in adolescents in Bharatpur, Chitwan. The majority of patients fall in grade 1 and 2 categories followed by grades 4 and 5 of DHC of IOTN grading.

Prevalence of malocclusion in adolescents according to sex, caries experience, gingival bleeding and smile dissatisfaction

Objective: The propose of this study was to estimate the prevalence of malocclusion among adolescents and to assess the differences of this prevalence according to sex, experience of caries, gingival bleeding, and smile dissatisfaction. Methods: A cross-sectional study was conducted with 600 adolescents from 10 to 16 years old, who were identified and selected from public schools’ records. Intraoral and extraoral examinations were performed following World Health Organization recommendations and included: number of decayed, missing and filled teeth, presence of gingival bleeding, and occlusal condition. The latter was assessed based on information of Dental Aesthetic Index, and Foster and Hamilton Index, in addition to the evaluation of dental midline, facial and smile pleasantness according to Capelozza Filho classification. Smile dissatisfaction was also evaluated. Bivariate Poisson regression with robust variance was used to compare prevalence rates. Results: The prevalence of malocclusion, caries experience, gingival bleeding and smile dissatisfaction were 96.0%, 52.3%, 55.8%, and 49.4%, respectively. The prevalence of malocclusion was higher among adolescents with gingival bleeding. Statistically significant associations were noticed between crowding of the upper and lower anterior teeth and gingival bleeding, as well as among Class III molar relationship, deviation of the dental midline, anterior open bite, anterior crossbite, and caries experience. Smiles classified as acceptable or unpleasant were associated with dissatisfaction. Conclusion: These findings have evidenced a higher prevalence of malocclusion among adolescents and its association with caries experience, gingival bleeding, and smile dissatisfaction.

Temporomandibular joint disc repositioning and occlusal splint for adolescents with skeletal class II malocclusion: a single-center, randomized, open-label trial

BackgroundTemporomandibular joint (TMJ) disc repositioning through open suturing (OSu) is a new disc repositioning method. Its result for adolescents with condylar resorption and dentofacial deformities combined with and without postoperative occlusal splints (POS) has not been well studied.ObjectiveThis study was to evaluate and compare the effects of OSu with and without POS in the treatment of TMJ anterior disc displacement without reduction (ADDwoR) in adolescent skeletal Class II malocclusion.MethodsA total of 60 adolescents with bilateral ADDwoR were enrolled in this study. They were randomly allocated into two groups: OSu with and without POS. Magnetic resonance imaging (MRI) and lateral cephalometric radiographs were used to measure changes in condylar height and the degree of skeletal Class II malocclusion from before operation and at 12 months postoperatively. Changes in these indicators were compared within and between the two groups.ResultsAfter OSu, both groups exhibited significant improvements in condylar height and occlusion at the end of 12 months follow-up (P < 0.05). The group of OSu with POS had significantly more new bone formation (2.83 ± 0.75 mm vs. 1.42 ± 0.81 mm, P < 0.001) and improvement in dentofacial deformity than the group of OSu only (P < 0.05). The new bone height was significantly correlated with POS (P < 0.001), the changes of SNB (P = 0.018), overjet (P = 0.012), and Wits appraisal (P < 0.001).ConclusionThese findings indicated that OSu can effectively stimulate condylar regeneration and improve skeletal Class II malocclusion in adolescents with bilateral ADDwoR. The results are better when combined with POS.Trial registrationThis trial was prospectively registered on the chictr.org.cn registry with ID: ChiCTR1900021821 on 11/03/2019

Impact of malocclusions on oral health-related quality of life among adolescents.

Systematic review and meta-analysis of randomized controlled trials, non-randomized and observational studies, and previous systematic reviews if matching PECOS strategy. The protocol of the study was registered on PROSPERO. An electronic search was conducted in the following five databases: The Cochrane Library, PubMed, Web of Science, Scopus, and CINAHL. The search was carried out to cover the literature up to June 15, 2022. In addition, ClinicalTrials.gov and PROSPERO were searched for detecting any relevant unpublished data and ongoing studies. The review was defined in PECOS format as follows: population (P), healthy adolescents (ASA Class I or II; age 10-19); Exposure (E), malocclusion and/or need of orthodontic therapy as determined by professionals utilizing validated standardized tools such as Index of Orthodontic Treatment Need, Index of Complexity, Outcome and Need, Peer Assessment Rating, Dental Aesthetic Index, or any well-described tool; comparison (C), no malocclusion and/or need of orthodontic therapy as determined by professionals utilizing validated standardized tools; outcome (O), self-reported oral health-related quality of life (OHRQoL) using validated tools; study design (S), randomized clinical trials, non-randomized/observational studies (prospective and cross-sectional studies with untreated/no-malocclusion controls), and previous systematic reviews if matching PECOS strategy. Studies assessing ASA Class III or higher, craniofacial conditions, previous or ongoing orthodontic or surgical treatment, and case studies were excluded. Screening and data extraction and management, risk of bias (RoB), and quality assessments were conducted by four independent investigators. RoB was assessed based on the guidelines of the Swedish Agency for Health Technology Assessment and Assessment of Social Services. A total of 13 studies (non-randomized studies of cross-sectional design) were included in the qualitative synthesis, of which, 4 studies were included in the quantitative synthesis. Meta-analysis showed that malocclusions (measured with DAI) in adolescents aged 11-14 years old have a negative impact on OHRQoL (measured with CPQ 11-14 short form) (number of studies = 4, rate ratio/prevalence ratio = 1.15, 95% confidence interval = 1.12-1.18, I2 = 0.03%, Q3 = 0.09, certainty level = moderate). Moderate level of evidence suggests that malocclusions in adolescents have a negative impact on the oral health-related quality of life.

Prevalence and influencing factors of malocclusion in adolescents in Shanghai, China

BackgroundThe main purpose of the study was to investigate the prevalence and related risk factors of malocclusion in permanent dentition among adolescents in Shanghai, and provide basic data for government’s preventive strategies and intervention plans.Methods1799 adolescents aged 11–15 years old from 18 middle schools in 6 districts of Shanghai were recruited to investigate oral health status and related risk factors using cluster random sampling method in 2021. Malocclusion and caries were examined by on-site inspection. The investigation criteria referred to Bjoerk and the recommendation of the WHO. The malocclusion inspection items included molars relationship, canine relationship, overbite, overjet, midline displacement, anterior crossbite, posterior crossbite, scissors bite, crowding and spacing. The subjects were asked to fill in a questionnaire including parents’ education level, oral health behaviors and dietary habits. The chi-square test and logistic regression analysis were used to analyze the relationship between malocclusion and risk factors.Results1799 adolescents were included in the study and the prevalence of malocclusion in adolescents in Shanghai was 83.5%, and the proportion of molar relationship class I, class II, and class III was 48.9%, 14.7%, and 19.0%, respectively. The most common occlusal characteristic of malocclusion was anterior crowding, followed by midline irregularities and deep overbite, with prevalence rates of 44.8%, 39.0% and 38.6%, respectively. The prevalence rate of adolescents with caries was 34.3%. Those who had dental caries and preferred soft food were more likely to have abnormal occlusal characteristics (p < 0.05).ConclusionThe prevalence of malocclusion in adolescents in Shanghai is high, so it is of great significance to strengthen oral health education, allocate proper preventive strategies and carry out the early correction if necessary.

УСОВЕРШЕНСТВОВАНИЕ КОМПЛЕКСНОЙ ТЕРАПИИ ГИПЕРТРОФИЧЕСКОГО ГИНГИВИТА У ПАЦИЕНТОВ С ПАТОЛОГИЕЙ ПРИКУСА

The prevalence of inflammatory periodontal diseases, and in particular hypertrophic gingivitis, among adolescents ranges from 50 - 99%, which is often combined with malocclusion and this combination is about 70% of cases, which is an urgent and unresolved problem of modern periodontology and orthodontics. Therefore, the study of the issues of correlation between the severity of morphological, functional and aesthetic disorders of the masticatory-speech apparatus and the severity of the inflammatory process in the tissues of the periodontal complex is important and necessary for the development of modern complexes for the treatment of adolescents with hypertrophic gingivitis and malocclusion class 1 according to Angle during the hormonal period. perestroika. The purpose of the study: to optimize the complex treatment of malocclusion in adolescents with hypertrophic gingivitis. 32 patients aged 14 to 17 years with E.H. class I malocclusion. ANGLE and mild edematous hypertrophic gingivitis were included in this study. All patients underwent orthodontic treatment using non-removable orthodontic equipment (brackets), but for periodontal treatment, patients were divided into 2 groups of 16 people, one group underwent traditional conservative periodontal treatment, and the other group of patients underwent removal of dental biofilm using GBT therapy on apparatus "PROPHYLAXIS MASTER". Before treatment, after 6 months and after the removal of orthodontic equipment, an index assessment of the state of periodontal tissues was carried out and a comparison of the average statistical data of teleradiography to study changes in the size of the facial part of the skull before and after orthodontic treatment, as well as a study of the correlation between the studied parameters was carried out for all patients. According to the results of the study, it was found that during orthodontic treatment of adolescents with malocclusion class I according to E.H. ANGLE and GBT-periodontal therapy increases the effectiveness of complex treatment for this category of patients by 40% compared to traditional therapy for inflammatory periodontal diseases at the stages of orthodontic treatment.

Malocclusion in adolescents in the State of São Paulo: spatial and hierarchical analysis

The scope of this study was to analyze the spatial distribution of malocclusion (MO), estimate the prevalence and evaluate the associated factors in adolescents. It was a study with results of 5,558 adolescents aged 15 to 19 from the São Paulo Oral Health (SB) 2015 survey. The outcome was MO. Sociodemographic aspects, access to dental services, dental caries and tooth loss were the independent variables. A total of 162 municipalities in the state of São Paulo were included and spatial statistics techniques were applied. Hierarchical logistic regression models were performed. The prevalence of MO was 29.3%. There was a spread pattern between the types of MO and positive detachment (p<0,05). Non-white adolescents (OR=1.32, 95%CI: 1.24-1.42), with less years of schooling (OR=1.30, 95%CI: 1.22-1.42), with teeth extracted due to caries (OR=1.40, 95%CI: 1.03-1.88) were more likely to have MO. Adolescent access to dental consultation did not contribute to reducing the chance of developing MO, regardless of whether the dental consultation occurred less (OR=2.02, 95%CI: 1.65-2.47) or more than one year before (OR=1.63, 95%CI: 1.31-2.03). Thus, the occurrence of MO is unequally distributed in the state of São Paulo and associated with sociodemographic conditions, access to consultations and tooth loss due to caries.

Malocclusions and quality of life among adolescents: a systematic review and meta-analysis.

Malocclusions in adolescents might have a negative impact on oral health-related quality of life (OHRQoL). Potential confounding variables (confounders) such as age, gender, caries, and socioeconomic status may skew the real relationship between malocclusions and OHRQoL. To analyse the effect of malocclusions in adolescents on OHRQoL, when controlled for potential confounders. Five databases (PubMed, Cochrane Library, Cinahl, Scopus, and Web of Science) were searched up to 15 June 2022. Studies in which OHRQoL in 10-19-year olds with and without malocclusions were compared. Screening, data extraction, and quality assessments were performed by four investigators independently. Risk of bias was assessed according to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) guidelines. To be included, studies had to control for confounders. Certainty of evidence was assessed with GRADE. Thirteen cross-sectional studies with low and moderate risk of bias were included in the qualitative synthesis. Four of these were also included in the quantitative synthesis (meta-analysis). The 13 studies in the qualitative synthesis displayed a large variation among the indices used for malocclusion ratings, as well as in instruments measuring OHRQoL. There was moderate quality of evidence that malocclusions have a negative effect on OHRQoL. The four articles included in the quantitative synthesis (meta-analysis) measured malocclusions with DAI and OHRQoL with CPQ 11-14 short form. There was moderate quality of evidence that malocclusions have a negative effect on OHRQoL (RR/PR 1.15, 95% CI 1.12-1.18, 3672 participants). There is moderate quality of evidence that malocclusions in adolescents have a negative impact on OHRQoL, after taking relevant confounders into consideration. Future studies should ideally use standardized measures for malocclusion ratings and OHRQoL. PROSPERO. CRD42020186152.

Contextual and Individual Determinants of Anterior Open Bite in Adolescents

ObjectiveStudying the broader determinants of anterior open bite (AOB) may guide more equitable policies.This study estimates the prevalence of AOB in Brazilian adolescents and its association with contextual and individual determinants. MethodologyThe data for dentofacial anomalies in 15- to 19-year-olds from the National Oral Health Survey SBBrasil 2010 were analysed (N = 4748). AOB was based on the Dental Aesthetic Index (AOB = 0; AOB > 0); the contextual variables were the Human Development Index (HDI) and the Gini Index (2010). The individual sociodemographic variables included sex (male, female), self-reported skin colour/race (white, black, brown, and indigenous + yellow), family income (≥4 minimum wage [MW]; 0–3 MW), and educational attainment (ideal, delayed). The individual clinical variables were decayed, missing, and filled teeth (DMFT) (0, ≥1), first permanent molar loss (0, ≤3, 4), and molar relationship (normal, half cusp, full cusp). Multilevel logistic regression models with random intercepts and fixed slopes were used to estimate odds ratios (ORs) and confidence intervals (95% CIs). ResultsAOB prevalence in Brazil was 8.78% (95% CI, 6.85–11.20) at 15 to 19 years of age. The lowest prevalence was in São Luis (2.63%; 95% CI, 0.58–11.03) and the highest was in João Pessoa (29.85%; 95% CI, 15.93–48.85), both capitals of the northeast Brazilian region. A higher prevalence of AOB (OR, 1.71; 95% CI, 1.04–2.80) was observed in municipalities with a lower HDI. Adolescents who declared their skin colour black, with lower family income, with delayed education, with DMFT ≥ 1, who lost 4 permanent first molars, and who had a complete molar cusp relationship were more likely to have AOB. ConclusionsAOB varied amongst Brazilian municipalities. The HDI plays an important role in the prevalence of AOB; individual social determinants have also been associated with AOB malocclusion in adolescents.

Sella turcica anomalies and its association with malocclusion – a lateral cephalometric study

The aim of the study is to estimate the prevalence of sella turcica anomalies on lateral cephalograms of individuals with malocclusion, so as to utilize it as a predictive indicator of malocclusion in adolescents. Lateral cephalograms of 224 subjects out of 250 aged between 8-18 years with good visibility of cephalometric structures including sella turcica were assessed for the variants of malocclusion. The study group consisted of 133 cephalograms with abnormal sella turcica, while the control group consisted of 91 cephalograms without any abnormality. Cramer’s V test was applied to find out association of classes of malocclusion and Sellar anomalies, and chi-square test was applied to know the frequency of each sellar anomaly among the class-wise distribution within the subjects. Males are more associated with sellar anomalies as compared to females. A significant association between skeletal classes of malocclusion and sella turcica with Cramer’s V value of 0.365 and significance of 0.001; so, it is clear that Class I malocclusion is associated with normal anatomy, while individuals with Class II and III is associated with sellar anomalies. An early predictive sign for prompt orthodontic intervention and correlating it with skeletal malocclusion can benefit both patients, as well as clinicians for interventional treatment.

Analysis of the correlation between malocclusion, bad oral habits, and the caries rate in adolescents.

BackgroundMalocclusion deformity and caries are common oral diseases in adolescents. In order to explore the correlation between malocclusion deformity and caries prevalence in adolescents, this study analyzed the influence of factors such as poor oral habits on caries in adolescents.MethodsIn this study, 1,093 adolescents aged 11 to 14 enrolled in 2–3 schools in Zhangjiakou area from September 2020 to June 2021 were selected as the research subjects. The basic data of these adolescents were collected by questionnaires. Malocclusion and caries were examined by on-site inspection. Their bad oral habits were also investigated. After data collection, the chi-square test, logistic regression, the Mann-Whitney U test, and the Kruskal-Wallis H test were used for multivariate analysis.ResultsThe results showed that the incidence of malocclusion was 72.66% and the caries rate was 68.8% among adolescents aged 11–14 in this area. The 4 bad oral habits of biting, mandibular protrusion, lateral chewing, and mouth breathing were the influencing factors of malocclusion in adolescents. Bad oral habits, malocclusion, and frequent consumption of sugary beverages were independent risk factors for caries in adolescents, and significantly positively correlated with the caries rate.ConclusionsMalocclusion and the four bad oral habits were independent risk factors of caries in adolescents.

ADOLESCENTS WITH REMOVABLE CLASS II CORRECTORS EXPRESS HIGHER DISSATISFACTION AND ARE MORE LIKELY TO DISCONTINUE TREATMENT

Pacha MM, Fleming PS, Johal A. Complications, impacts, and success rates of different approaches to treatment of Class II malocclusion in adolescents: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2020;158:477-494.e7. doi: 10.1016/j.ajodo.2020.03.021. Epub 2020 Sep 2. PMID: 32888735. There is no information about funding. Systematic review with meta-analysis.

Alterations of oral functions and dental malocclusions in adolescents: a cross-sectional population-based study.

This article aims to assess whether alterations of oral functions (AOF) are associated with malocclusion (MO)'s type and severity. Cross-sectional study of a representative sample of 332 adolescents aged 12 years in São Luís-MA, Northeastern Brazil. MO criteria included Angle's classification, Dental Aesthetic Index, and other morphological problems. The AOF were evaluated by breathing, phonation, chewing, and swallowing. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using logistic and multinomial regression analyses (α=5%). Mouth breathing was associated with defined (OR=3.84; 95%CI=1.45-10.12), disabling (OR=4.34; 95%CI=1.99-9.49), and class III (OR=4.15; 95%CI=1.19-14.54) MO. Phonation problems were associated with defined (OR=2.01; 95%CI=1.02-4.39), disabling (OR=3.04; 95%CI=1.55-5.96), and Class II (OR=2.02; 95%CI=1.28-3.18) MO. Chewing disorders were associated with posterior crossbite (PCB) (OR=2.32; 95%CI=1.12-4.82). Swallowing disorders were associated with Class III MO (OR=5.66; 95%CI=1.35-23.71), PCB (OR=6.13; 95%CI=2.76-13.62), and posterior open bite (OR=4.53; 95%CI=1.72-8.92). Breathing and phonation alterations are associated with MO in anterior arch segments, while chewing and swallowing disorders, in the posterior segments.

The Effect of Condylar Regeneration After Different Disc Repositioning Surgeries in Adolescents with Skeletal Class II Malocclusion

To evaluate the effect of different temporomandibular joint (TMJ) disc repositioning surgeries for the treatment of anterior disc displacement (ADD) in juvenile patients with skeletal Class II malocclusion. Patients (< 20 years, cervical vertebral maturation stage, IV-V) who had bilateral TMJ ADD with skeletal Class II malocclusion were treated by disc repositioning surgery (mini-screw anchor, [MsA]; or opening suturing, [OSu]). Magnetic resonance imaging (MRI) and lateral cephalometric films before and more than 12 months after surgery were collected from all patients. Changes of SNA, SNB, ANB, incisor overjet, pogonion position (pg'-G'), and condylar height were measured before and after surgery in different disc reposition surgeries and compared by statistical analysis. Eighty-four patients with an average age of 16.44 years and follow-up time of 14.60 months (12 to 33 months) were included in the study. Among them, 16 patients had a mean follow-up of 14.8 months without treatment before disc repositioning. Their condylar height was significantly decreased (P = .004) by MRI measurement. Six patients who had cephalometric films showed significantly decreased SNB (P = .042) and increased overjet (P = .037). After disc repositioning by either OSu (54 cases) or MsA (30 cases), condylar height, SNB were significantly increased and overjet, Pg'-G', ANB were decreased in both groups (P < 0.001). There was more new bone height in OSu than MsA (P = .004), but no significant differences in SNB, ANB, overjet and Pg'-G' between the 2 groups (P > .05). The new bone height was significantly correlated with the surgical method (P = .029), age (P = .015), SNB (P = .008), overjet (P = .048) and pg'-G' (P = .001). Both types of disc repositioning method can effectively promote condylar regeneration and improve skeletal Class II malocclusion in adolescents with ADD. Disc repositioning by OSu obtained more new bone height than MsA.

Total maxillary arch distalization with modified C-palatal plates in adolescents: A long-term study using cone-beam computed tomography

The aims of this study were to evaluate the long-term skeletodental effects, the volume of maxillary tuberosity, and airway space changes after maxillary molar distalization using modified C-palatal plate (MCPP) in adolescents with Class II malocclusion. The sample consisted of 20 adolescent patients (MCPP group; mean age, 12.9±1.0year) who underwent bilateral distalization of their maxillary dentition and 20 subjects as a control group. In the MCPP group, cone-beam computed tomography images were taken before distalization, at the end of the treatment, and during retention with a minimum of a 3-year posttreatment follow up period. Repeated measures ANOVA followed by post-hoc analysis with the Bonferroni test were used to identify significant differences between time points. After the long-term observation period, sagittal skeletal and dental relationships were maintained (there were no significant changes in ANB, occlusal plane angle, and overjet postretention). The vertical skeletal dimension did not change during treatment and was stable at the long-term follow-up (the mandibular plane angle and ANS-Me were relatively well maintained). The volume of the maxillary tuberosity showed no significant change during long-term retention. However, the volume was significantly smaller in the treatment group than in the control group (P<0.0001). There were no significant airway space changes after distalization and the postretention period. In addition, there was no significant difference between the MCPP and control groups. Improved sagittal skeletal and dental relationships because of treatment were maintained in the long-term evaluation. There was no negative long-term effect on airway space associated with the maxillary arch distalization. Therefore, these findings might be beneficial for clinicians in diagnosis and treatment planning for Class II malocclusion in adolescents.